Trudności w leczeniu ciężkich postaci zapalenia błony naczyniowej u dzieci
Difficulties in Severe Uveitis Treatment in Children
Lidia Puchalska-Niedbał, Urszula Kulik
Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. nadzw. PUM, FEBO
Summary: Purpose: To present the problems associated with managing children with uveitis with an emphasis on the treatment and complications.
Material and Methods: Observation included 32 children of both gender suffering from uveitis, treated in the Outpatient Ophthalmology Clinic in the period from 2008 to 2012. Age of children ranged from 3 months to 17 years. The examination included assessment of the visual acuity, slit lamp biomicroscopy, fundus examination, US, OCT, FA in both eyes. At each follow up visit, the occurrence of complications was noted.
Results: Patients were diagnosed with chronic or recurrent inflammation, which were treated with steroids (local and general). The cause of inflammation was found in 17 children. Despite full investigation implementation, diagnosis could not be established in 15 cases. The improvement was achieved in 25 patients, while disease recurrence was observed in 7 individuals. Complications such as: glaucoma, cataract, retinal detachment, cystoid macular edema (CME) occurred in 17 children as a result of a long, ongoing inflammatory process. Secondary complications in the form of Cushing edema were observed in 3 children after steroid therapy implementation. Therefore, they were treated in hospital pediatric ward.
Conclusions: Despite the tremendous technological progress, development of new diagnostics methods and ever newer and finer medicaments, management of patients with uveitis is still very difficult. Using various forms of therapy (especially steroids), severe secondary complications which may occur which additionally may complicate further patient management always should be considered.
Słowa kluczowe: dzieci, leczenie, trudności, zapalenie błony naczyniowej.
Keywords: children, difficulties, treatment, uveitis.